Expert Guidelines for Using FDA-Approved Vyjuvek™ (B-VEC)
In a recent article in the Journal of Dermatological Treatment, Dr. Amy Paller, Dr. Anne Lucky, Dr. Shireen Guide and their colleagues offer practical guidelines for doctors, patients, and caregivers on using the newly U.S. FDA-approved Vyjuvek™ (B-VEC) to treat Dystrophic Epidermolysis Bullosa (DEB).
These considerations come from a review of existing research and the experiences of healthcare providers who were involved in the B-VEC clinical trial or started using B-VEC after it was approved.
The recommendations outlined in the article include:
Assessment and Prioritization:
- Assess the affected areas, considering blisters, erosions, chronic wounds, infections, and overall wound care habits.
- Prioritize initial treatment for wounds that impact daily activities, as the weekly dose of B-VEC may not cover all wounds at once.
Special Considerations by Age:
- Infants may need special care in high-risk areas like the diaper region to prevent trauma.
- Early treatment for congenital skin absence in DEB patients can prevent long-term complications.
- Prioritize treating hands and feet to reduce the risk of deformity from trauma.
Skin Cleansing:
- Clean wounds with saline or gentle cleaners before B-VEC application.
- Be cautious with additives like bleach or acetic acid, ensuring thorough rinsing to avoid interfering with B-VEC.
Application Process:
- Apply B-VEC to clean, dry wounds, spacing droplets evenly.
- Cover treated wounds with a hydrophobic layer, followed by standard dressings to protect and absorb drainage.
Managing Blisters and Discomfort:
- Drain blisters properly, leaving the roof intact to protect the wound.
- Ensure comfort by adjusting the environment, like turning off forced air, and using pillows for support.
Post-Application Care:
- Maintain the hydrophobic layer for about 24 hours.
- Follow standard wound care routines after removing the hydrophobic layer, keeping wounds covered to prevent scabbing.
Addressing Wound Infections:
- Monitor for infections and manage them with antibiotics as needed, ensuring they do not interfere with B-VEC.
Surgical Considerations:
- B-VEC can aid in post-surgical healing, such as after hand surgeries, SCC removal, or around G-tube sites.
- Potential new applications include ophthalmic uses for improving visual acuity in DEB patients.
For more detailed guidelines and specific recommendations, please refer to the full version of the article linked below.
